A clinical study was undertaken to 1) confirm observations that tissue culture prolongs allograft skin survival in man; 2) study the various mechanisms which would possibly explain the above phenomenon; and 3) assess the clinical potential of using tissue culture skin allografts. During the past 6 months, nine randomly selected patients received cultured skin allografts. Six other patients constituted our pilot group. Two patients received two allografts; therefore, 17 transplantations were done. The skin from the donor was tissue cultured 3 to 18 weeks. Analyses of the allografts included clinical observations and biopsies of the grafted areas to determine Barr body characteristics and HL-A patterns. Our clinical trials thus for do not show that tissue culture leads to prolonged skin graft survival, but there are 4 cases that show survival of fibroblasts and 1 case with HL-A antigens. We cannot make the assumption that individual fibroblast survival correlates directly with graft survival. We find no definitive report in the literature concerning using histologic and scanning electron microscopy criteria to optimize the time of transplant based on the roles of the vascular endothelial cells and the basement membrane.